Medical Necessity: ICD-10-CM Coding and Reimbursement

Wed, 06/04/2025 - 09:04
Webinars
Coding and Documentation, Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Shelley C. Safian, PhD, RHIA, MAOM CCS-P, CPC-I, shares tips on ensuring accurate coding and reimbursement to support medical necessity.

Reduce Physician E/M Denials with Compliant Modifier -25 Reporting

Tue, 06/03/2025 - 10:03
Webinars
Billing and Claims, Coding and Documentation, Compliance, Denials and Appeals, Revenue Integrity

Betty A. Hovey, BSHAM, CCS-P, CDIP, CPC, COC, CPMA, CPCD, CPB, CPC-I, discusses how to support compliant reporting of modifier -25 and reduce denials.

Recipe for Success: 2025 State of the Revenue Integrity Industry

Mon, 06/02/2025
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Revenue Integrity

Revenue integrity professionals need to understand how new elements in the healthcare industry, from changing regulations to advances in technology

Exploring the OIG Workplan

Mon, 06/02/2025 - 10:14
Webinars
Billing and Claims, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Reimbursement and Payment Methodologies, Revenue Integrity

Leigh Poland, RHIA, CCS, CDIP, CIC, explains how to use the Office of Inspector General's (OIG) Work Plan to identify internal audit opportunities, shore up reimbursement compliance, and protect revenue.

2025 State of the Revenue Integrity Industry Report

June 2, 2025
Industry Report
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Payer Contracting, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

NAHRI is celebrating the eighth annual Revenue Integrity Week (June 2–6) to acknowledge and raise awareness of revenue integrity professionals’ incredible contributions in the healthcare industry. To further support the goals and mission of revenue integrity and advance the development of...

NAHRI Leadership Council Meeting (05-22-25)

Thu, 05/22/2025 - 16:57
Council Resources
Billing and Claims, Coding and Documentation, NAHRI Leadership Council, Revenue Integrity

Study shows higher upcoding rates in outpatient settings

Wed, 05/21/2025
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Denials and Appeals, Monitoring and Audits, News, Revenue Integrity

New findings suggest upcoding is becoming a more common practice in emergency departments, urgent care centers, and physician offices. 

Successfully managing audits and avoiding compliance pitfalls

Wed, 05/14/2025
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Revenue Integrity

Gain insights into CMS’ and the Office of Inspector General’s audit targets and learn how to put this knowledge to work at your organization.

Leveraging CDI to reduce revenue leakage and denials

Wed, 04/30/2025
Revenue Integrity Insider
Coding and Documentation, Revenue Integrity

Gan insights into how CDI can help shore up revenue integrity for office visits and ancillary services.

Skin substitute coding changes in the April 2025 OPPS update

Wed, 04/30/2025
Revenue Integrity Insider
Coding and Documentation, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS recently published the April 2025 Outpatient Prospective Payment System (OPPS) update to highlight coding changes for skin substitute products that took effect on April 1.

Pages